Heealth Prod
duct Declarration v2.0
0 EcoW
Worx® Tile
e with Solu
ution Q Exttreme® Nyylon 6 Fibeer by P
Patcraft® CLASSSIFICATION: 09
9 68 13 PROD
DUCT DESCRIPTTION: THIS HPD
D REPRESENTS ALL CARPET TILE STYLES WITTH ECOW
WORX® BACKIN
NG AND SOLUTTION Q EXTREM
ME® NYLON 6 FFACE FIBER RANG
GING FROM 14‐40 OZ/SY. created vvia: toxnot.com
m Section 1: Summa
ary CONTTENT INVENTO
ORY Thresshold (per material) 100
0 ppm 1,0
000 ppm Perr GHS SDS  Per OSHA MSDS her Oth
purities Residuals and imp
considered in X off Y materials  ssee Section 2: M
Material Notess  ssee Section 5: G
General Notes
Based on the selected C
Content Inventtory Threshold
d:
 Yes No
…………………................ Characterrized………………
Are the PPercent Weightt and Role provvided for all subbstances? Screenedd………………………
………………….............. Are all su bstances screeened using Prio
ority Hazard Liists with resultts disclosed?  Yes No
Identifiedd……………………
…………………................. Are all su bstances disclo
osed by Namee (Specific oor Generic) and Identifier?  Yes No
CONTTENT IN DESCENDING ORDER
R OF QUANTITYY Summ
mary of producct contents and
d results from screening indiviidual chemical substances aggainst HPD Prio
ority Hazard Lissts and the GreenScree
en® for Safer Chemicals. The HPD does not ng or handling this product w
will expose assesss whether usin
nces or any heaalth risk. Referr indiviiduals to its chemical substan
to Secction 2 for furtther details. MATEERIAL | SUBST
TANCE GREENSSCREEN SCORE HAZARD TYPEE; ATE (limestone
e) LT ‐ UNK ;NY
YLON 6 LT ‐ CALCIUM CARBONA
UNK ;; ETHENE, 1‐OC
CTENE COPOLY
YMER LT ‐ UNK
K ; VINYL ACETTATE / ETHYLEN
NE COPOLYMEER LT ‐ UNK ;HY
YDROCARBON
N N LT ‐ UNK ;FIB
BERGLASS LT ‐ UNK ;POLYETH
HYLENE RESIN
TEREP
PHTHALATE(PET) LT ‐ UNK RES;ALUMINUM
M TRIHY
YDRATE BM ‐ 2
2 ;QUARTZ BM
M ‐ 1 CAN;ETHY
YLENE,1‐HEXAN
NE COPO
OLYMER LT ‐ UNK ;SILICA BM
M ‐ 1 ; 1,4‐BIS(2
2‐ETHYLHEXYL)) SODIUM SULFOSUC
CCINATE LT ‐ U
UNK ;MODIFIED
D ACRYLIC TRIDECYL ALCO
OHOL ETHOXYLLATE LT ‐ BINDER LT ‐ UNK ;T
UNK ;;POLYVINYL ALLCOHOL LT ‐ UNK ;MAGNESIUM CARB
BONATE LT ‐ UN
NK ;LATEX ADD
DITIVE LT ‐ UNK ;CARBON BLACK BM ‐ 1 CAN; LINEAR LOW DENSITY POLY
YETHYLENE PE) LT ‐ UNK ;FIBER COLORAN
NTS (Various) LT ‐ UNK ; (LLDP
3 contents: 0
Number of GreenScreeen® BM‐4/BM‐3
Contentss highest conceern GreenScreeen® Benchmarrk or List Translatoor Score: BM –– 1 (Form‐speccific hazard only) Nanomatterial: No ORY AND SCREEENING NOTES INVENTO
Ingrediennts have been screened again
nst HPD authoritative lists, but not aall CAS #'s havee been discloseed to protect p
proprietary formulat ions. VOLA
ATILE ORGANIC
C COMPOUND (VOC) CONTEN
NT Mateerial (g/l): Regulatory (g/l): Does the product co
ontain exemptt VOCs? No Are u
ultra‐low VOC ttints available?? Not Applicablle CERTIFIC ATIONS AND C
COMPLIANCE Multi‐atttribute: Cradle to Cradle V3.1
1 VOC Emisssions: Green Label Plus (com
mmercial) See Sectiion 3 for additiional listings. Selff‐Published Third Party Verifie
ed VERIFIER: VERIFICATION
N #: SCREENIING DATE:
RELEASEE DATE:
EX
XPIRY DATE:
Section 2: Conten
nt in Descending Ord
der of Quan
ntity This ssection lists maaterials in a pro
oduct and the substances in each material based on the IInventory Threeshold for each
h material. If residu
uals or impuritties from the m
manufacturing or extraction p
processes are cconsidered for a material, these are inventoried and charaacterized to the
e extent descriibed in the Material and/or G
General Notes.. Chemical substances are scrreened againstt the HPD Prioriity Hazard Listss for human an
nd environmen
ntal health imp
pacts. Screenin g is based on b
best available iinformation; “N
Not Found” does not necessarilyy mean there iis no potential hazard associaated with the pproduct or its ccontents. Moree information about Priority e GreenScreen
n can be found online: www.h
hpd‐collaborattive.org and ww
ww.greenscreeenchemicals.org. Hazarrd Lists and the
C
CALCIUM CAR
RBONATE (Lim
mestone) %
%: 25‐45% GS: LT ‐ UNK H
HAZARDS: AGENCY(IESS) WITH WARN
NINGS:
N
NYLON 6 %
%: 0‐35% GS: LT ‐ UNK H
HAZARDS: AGENCY(IESS) WITH WARN
NINGS:
ID: 13
317‐65‐3 RC: PI
NA NO: No
ROLE: Backing Filler ID: 25
5038‐54‐4 RC: No
NA NO: No
ROLE: Face Fiber EETHENE, 1‐OC
CTENE COPOLLYMER ID: 26
6221‐73‐8 %
%: 5‐15% GS: LT ‐ UNK RC: No
NA NO: No
H
HAZARDS: AGENCY(IESS) WITH WARN
NINGS:
ROLE: Backing mer Polym
V
VINYL ACETATTE / ETHYLENE COPOLYMEER ID: 24
4937‐78‐8 %
%: 3‐10% GS: LT ‐ UNK RC: No
NA NO: No
H
HAZARDS: AGENCY(IESS) WITH WARN
NINGS:
ROLE: Latex mer Polym
H
HYDROCARBO
ON RESIN ID: 67
7891‐77‐4 %
%: 3‐10% GS: LT ‐ UNK RC: No
NA NO: No
H
HAZARDS: AGENCY(IESS) WITH WARN
NINGS:
ROLE: Backing Additive FFIBERGLASS ID: 65
5997‐17‐3 %
%: 3‐10% GS: LT ‐ UNK RC: No
NA NO: No
H
HAZARDS: NINGS:
AGENCY(IESS) WITH WARN
ROLE: orcement Reinfo
& Backing Filler POLYETHYLENE TEREPHTHALATE (PET) %: 3‐10% GS: LT ‐ UNK HAZARDS: RES AGENCY(IES) WITH WARNINGS:
AOEC ‐ Asthmagens
ALUMINUM TRIHYDRATE ID: 21645‐51‐2 %: 1‐5% GS: BM ‐ 2 RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Flame Retardant ID: 25038‐59‐9 RC: PC
NANO: No
ROLE: Primary Backing Rs
QUARTZ (Residual in CaCO3) ID: 14808‐60‐7 %: 1‐5% GS: BM ‐ 1 RC: PI
NANO: No
HAZARDS: CAN CAN AGENCY(IES) WITH WARNINGS:
MAK Carcinogen
IARC ROLE: Backing Filler Residual Carc. 1
1
ETHYLENE, HEXANE‐1 COPOLYMER ID: 25213‐02‐9 %: 1‐5% GS: LT ‐ UNK RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Backing Polymer SILICA (Residual in CaCO3) ID: 7631‐86‐9 %: 1‐3% GS: BM ‐ 1 RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Backing Filler Residual 1,4‐BIS(2‐ETHYLHEXYL) SODIUM SULFOSUCCINATE ID: 577‐11‐7 %: 0.1‐1% GS: LT ‐ UNK NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Latex Additive RC: No
MODIFIED ACRYLIC BINDER ID: 61467‐52‐5 %: 0.1‐1% GS: LT ‐ UNK RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Reinforcement Binder TRIDECYL ALCOHOL ETHOXYLATE ID: 78330‐21‐9 %: 0.1‐1% GS: LT ‐ UNK RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Latex Additive POLYVINYL ALCOHOL %: 0.1‐1% GS: LT ‐ UNK HAZARDS: AGENCY(IES) WITH WARNINGS:
ID: 9002‐89‐5 RC: No
NANO: No
ROLE: Latex Additive MAGNESIUM CARBONATE ID: 546‐93‐0 %: 0.1‐1% GS: LT ‐ UNK RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Filler Residual LATEX ADDITIVE ID: UNDISCLOSED %: 0.1‐1% GS: LT ‐ UNK RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Latex Additive CARBON BLACK ID: 1333‐86‐4 %: 0.1‐1% HAZARDS: CAN CAN GS: BM ‐ 1 RC: No
AGENCY(IES) WITH WARNINGS:
CA Prop 65 IARC NANO: No
ROLE: Pigment
cancer
2B
LINEAR LOW DENSITY POLYETHYLENE (LLDPE) ID: 9002‐88‐4 %: 0.1‐1% GS: LT ‐ UNK NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Backing Additive RC: PC
FIBER COLORANTS (Various) ID: UNDISCLOSED %: 0% GS: LT ‐ UNK RC: No
NANO: No
HAZARDS: AGENCY(IES) WITH WARNINGS:
ROLE: Fiber Colorant Section 3: Certificcations and
d Complian
nce This ssection lists applicable certification and standards compliance informat ion for VOC em
missions and V
VOC content. O
Other types of health or environmental performaance testing orr certifications completed forr the product m
may be provideed. MULLTI‐ATTRIBUT
TE Cradle to
o Cradle V3.11 CERTIFYING PARTY: McDonough B
Braungart Design Chemistry DC) (MBD
EXPIR
RY DATE: Marcch 21, 2017 ISSUE DA
ATE: May 21, 20008
CERTIFIER
R OR LAB: Crad
dle to Cradle Product Innovattion Institute
APPLICABLE FACILITTIES: ALL CERTIFICATE AND C
COMPLIANCE N
NOTES: http:///www.c2ccertiffied.org/produucts/scorecard//ecoworx‐carp
pet‐tiles VOC EMISSIONS Green Laabel Plus (com
mmercial) CERTIFYING PARTY: Carpet and Ru
ug Institute EXPIR
RY DATE: Septe
ember 30, 201
17 ISSUE DA
ATE: June 30, 22012
CERTIFIER
R OR LAB: UL
APPLICABLE FACILITTIES: Cartersville, Georgia CERTIFICATE AND C
COMPLIANCE N
NOTES: 9968 14X Predyyed Nylon with
h Amorphous R
Resin Backing
GLP 9
Section 4: Accesso
ories This ssection lists related products or materials that the manuffacturer requirees or recommeends for installation (such ass adhesives or fasten
ners), mainten
nance, cleaningg, or operations. For informattion relating too the contents of these relateed products, reefer to their appliccable Health Product Declaraations, if availaable. HPD URL:: N/A
COND
DITION WHEN RECOMMENDED OR REQUIR
RED AND/OR O
OTHER NOTES:
Appro
oved for use w
with EcoWorx® Tile installations. Cradle to C
Cradle Certifiedd™ V3.1 Silver r when used in conjunction w
with EcoW
Worx® Tile. LOKD
DOTS CARPET
T TILE ADHESIVE HPD URL:: N/A
COND
DITION WHEN RECOMMENDED OR REQUIR
RED AND/OR O
OTHER NOTES:
Appro
oved for use w
with EcoWorx® Tile installations. Cradle to C
Cradle Certifiedd™ V3.1 Silver r (http://www.c2ccerrtified.org/products/scorecard/shaw_5000
0_‐_shaw_induustries) SHAW
W 5000 CARP
PET TILE ADHESIVE Section 5: Genera
al Notes Section 6: Referen
nces MAN
NUFACTURER INFORMATIO
ON MANUFACTURER: SShaw Industries Group, Inc. RESS: ADDR
1010 V D Parrott Jr.. Pkwy, Dalton,, GA 30720 CONTACCT NAME: Kelliee Ballew TITLE: Srr. Product Sustainability Man
nager PHONE: 706‐532‐22000 EMAIL: [email protected] WEBSSITE: www.patcraft.com KEY A MSDS OSHA
Occupational S
O
Safety and Health Administraation Material SSafety Data Sh
heet GHS SSDS Globally Harmo
G
onized System of Classificatio
on and Labelin g of Chemicalss Safety Data SSheet Hazard Types AQU CAN Aquatic toxxicity Cancer GLLO MA
AM Global w
warming
Mammalian/
systemaatic/organ toxiicity PHY
REP
Physiccal Hazard (reactive)
Reprod
ductive toxicityy
DEV END Developme
ental toxicity Endocrine activity MU
UL NEEU Multiple hazards
Neuroto
oxicity
RES
SKI
EYE GEN Eye irritation/corrosivity Gene mutaation OZZO PB
BT Ozone d
depletion
Persiste
ent Bioaccumuulative Toxic
LAN
NF
Respirratory sensitizaation
Skin seensitization/
Irritation/corrosivityy Land toxicity ound on Priorityy Hazard Lists
Not fo
GreeenScreen (GS)) LT‐P1
LT‐1
List Transslator Possible Benchmark 1
List Transslator Likely Beenchmark 1
BM‐2
2 Benchmark‐4 (prefe
er – safer chem
mical)
Benchmark‐3 (use b
but still opporttunity for ovement) impro
Benchmark‐2 (use b
but search for safer substituttes)
LT‐UNK
List Transslator Benchmark Unknown ((insufficient informatiion from List TTranslator lists to benchmark) BM‐1
1 Benchmark‐1 (avoid
d – chemical of high concern)
UNK
Unknown
n (no data on LList Translator Lists)
BM‐U
U Benchmark Unspeccified (insufficie
ent data to benchmark) BM‐4
4 BM‐3
3 Recyycled Types PreC C PostC
Both Unk Nonee Preconsu
umer (Post‐Ind
dustrial) Postconssumer Both Pre
econsumer and
d Postconsume
er Inclusion
n of recycled co
ontent is unknown
Does not include recyccled content Otheer Nano
o Composed of nanoscalle particles or n
nanotechnologgy
Declaaration Level Self‐d
declared Indep
pendent Lab Secon
nd Party Third
d Party Appliicable Facilities Manufacturer’s self‐declaration ((First Party)
using results frrom an indepen
ndent lab Manufacturer’s self‐declaration u
de association or other intereested party
Veriffication by trad
Veriffication by inde
ependent certiifier
Manufacturing site
es to which testting applies
The Health Product Declaration (HPD) Open Standard provides for the disclosure of product contents and potential associated human and environmental health hazards. Hazard associations are based on the HPD Priority Hazard Lists, the GreenScreen List Translator, and when available, full GreenScreen assessments. The HPD Open Standard does not provide an assessment of health impacts throughout the product life cycle. It does not provide an assessment of exposure or risk associated with product handling or use. It also does not address potential health impacts of: (i) substances used or created during the manufacturing process unless they remain in the final product, or (ii) substances created after the product is delivered for end use (e.g., if the product burns, degrades, or otherwise changes chemical composition). The HPD Open Standard was created and is maintained and evolved by the Health Product Declaration Collaborative (the HPD Collaborative), a customer led organization composed of stakeholders throughout the building industry. The HPD Collaborative is committed to the continuous improvement of building products through transparency, openness, and innovation throughout the product supply chain. A disclosure completed in compliance with the HPD Open Standard is referred to as a “Health Product Declaration,” or “HPD.” The product manufacturer and any applicable independent verifier are solely responsible for the accuracy of statements and claims made in this HPD and for compliance with the HPD Open Standard noted.